title: Hypoglycaemia, fear of hypoglycaemia and quality of life in children with Type 1 diabetes and their parents.
abstract: OBJECTIVE
  To evaluate the association between fear of hypoglycaemia, episodes of hypoglycaemia and quality of life in children with Type 1 diabetes and their parents.
  
  
  METHODS
  This was a cross-sectional, population-based study of 325 children with Type 1 diabetes and their parents. The children were aged 2-18 years. A total of 325 parents of the patients aged 2-18 years and 196 of the patients themselves (aged 8-18 years) completed questionnaires including the PedsQL Diabetes Module, the Hypoglycaemia Fear Survey and Clarke's hypoglycaemia awareness questionnaire. Data were compared with HbA1c results and the history of severe hypoglycaemia episodes.
  
  
  RESULTS
  Parents with the highest levels of fear of hypoglycaemia reported that their children had a reduced quality of life (P < 0.001). Similarly children with the greatest fear also reported a reduced quality of life (P < 0.001); however a history of severe hypoglycaemia was not associated with the child's quality of life as perceived by the child or parent. Episodes of severe hypoglycaemia were associated with an increased fear of hypoglycaemia for the parents (P = 0.004) but not the children. Children in the highest fear quartile also had a higher HbA(1c) concentration compared with those in the lowest fear quartile [increase in HbA(1c) 7 mmol/mol (0.6%), P < 0.01].
  
  
  CONCLUSIONS
  Fear of hypoglycaemia and not episodes of hypoglycaemia per se is associated with increased psychological burden for children with Type 1 diabetes. Interventions to reduce fear of hypoglycaemia in these families may improve their quality of life.
authors.affiliation: Department of Endocrinology & Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
authors.forename: S R
authors.initials: SR
authors.lastname: Johnson
authors.forename: M N
authors.initials: MN
authors.lastname: Cooper
authors.forename: E A
authors.initials: EA
authors.lastname: Davis
authors.forename: T W
authors.initials: TW
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000628:therapy*; D005239:Fear; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D015994:Incidence; D008297:Male; D010044:Outpatient Clinics, Hospital; D010290:Parents; D011569:Psychiatric Status Rating Scales; D000297:Psychology, Adolescent; D002666:Psychology, Child; D011788:Quality of Life; D012720:Severity of Illness Index; D014904:Western Australia / Q000453:epidemiology
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human